Blind intubation device and related methodologies for endotracheal intubation

ABSTRACT

Disclosed is an apparatus and method to facilitate insertion of the endotracheal tube into the patient&#39;s trachea.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a divisional of U.S. application Ser. No. 16/428,344filed May 31, 2019 and that application is incorporated by reference.

STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT

Not applicable.

THE NAMES OF THE PARTIES TO A JOINT RESEARCH AGREEMENT

Not applicable.

REFERENCE TO AN APPENDIX SUBMITED ON A COMPACT DISC AND INCORPORATED BYREFERENCE OF THE MATERIAL ON THE COMPACT DISC

Not applicable.

STATEMENT REGARDING PRIOR DISCLOSURES BY THE INVENTOR OR A JOINTINVENTOR

Reserved for a later date, if necessary.

BACKGROUND OF THE INVENTION Field of Invention

The disclosed subject matter is in the field of apparatuses and relatedmethods of endotracheal intubation.

Background of the Invention

Endotracheal intubation is a medical procedure by which a tube, calledthe endotracheal tube, is inserted into the mouth and then into theairway (trachea) of a patient. Intubation is a prerequisite toventilator-assisted breathing and provides a medium through which aventilator may push air into the patient's lungs. Generally, intubationis employed in the event that a patient is unconscious, e.g.,anesthetized, or otherwise requires breathing assistance (for instance,when patients are too sick or injured to breathe on their own or duringcardiac arrest). Intubation is always required whenever a patient isgiven general anesthesia as the sedative paralyzes the patient'sdiaphragm, but is also employed in the event of respiratory failureincluding during out-patient surgeries. Patients may also have atemporary or chronic medical condition (e.g., pneumonia or COPD)requiring the use of a ventilator and thus endotracheal tube.

Intubation is a difficult and time consuming procedure. The success oftraditional methods of intubation is heavily dependent on the level ofskill of the attending physician or technician as proper placement canbe difficult to immediately verify and patient harm may occur as aresult. If the procedure takes too long, a patient can suffer injuriesdue to lack of oxygen to the brain.

Conventional methods of intubation favor when the patient is sedated ornot fully conscious, allowing for the mouth and airway to relax and thusfor easier insertion and placement of the tube. The patient is typicallyin a prone position immediately prior, and the individual inserting thetube typically stands at the patient's head. The Patient's mouth isopened and tongue is held out of the way while the tube is passedthrough the patient's throat until it rests within the trachea. When apatient is sedated or unconscious, intubation can take up to 30 secondsto complete by a medical professional in a carefully controlledhospital/clinical setting. If a patient is not sedated, or outside thehospital, intubation can take much longer. For example, outside ahospital during emergency situations encountered by first responders,mass casualty, policemen, firemen, EMT/EMSs, and military, intubation(aka “field intubation”) is considered to be “advanced life support”(ALS) and can take more than a minute and thirty seconds to accomplish.

Conventional methods of endotracheal intubation carry the risk of thetube being inadvertently placed into the esophagus rather than thetrachea. The risk of tube misplacement is higher during fieldintubations. See Katz S H, Falk J L. Misplaced endotracheal tubes byparamedics in an urban emergency medical services system. Ann Emerg Med.2001 January; 37(1):32-7 where misplaced endotracheal tubes were foundto occur 25% of the time in a study of 108 field intubations. Thismistake could hamper or altogether prevent proper respiration. As aresult, patients experience heightened risks of brain damage, cardiacarrest, and death, among other things. Any ventilation in the event ofmisplacement likewise poses serious medical risks. For instance,aspiration of the stomach via the esophagus can result in pneumonia andacute respiratory distress syndrome (ARDS). Further, improper placementof the tube within the trachea may lead to only one lung being properlyventilated, increasing the risk of pneumothorax or inadequateventilation. Use of the conventional method and apparatus also increasesthe risk of damaging the patient's teeth, the soft tissue in the back ofthe throat, and the vocal cords.

Conventional methods of intubation require a laryngoscope handle andblades of varying sizes and shapes, endotracheal tubes, and a means forsecuring the tube in place. These old means for securing theendotracheal tube in place generally consist of various speciallydesigned commercial products, but less preferable tape and ties are alsocommonly used as some of the specially designed products can be verycostly. Some of the products currently employed consist of assortedmasks, bite blocks, and various devices configured to deliver lidocaineto the trachea.

SUMMARY OF THE INVENTION

Accordingly, it is an object of the present disclosure to mitigate theassociated medical risks of intubation techniques by providing anapparatus and method to facilitate insertion of the endotracheal tubeinto the patient's trachea as well as reducing the amount of time takenfor intubation (e.g., from 30 seconds to 18 seconds). The disclosedapparatus and technique enables “blind” intubation, i.e., intubationwithout use of a laryngoscope. It is another object of the presentspecification to facilitate the insertion of an endotracheal tube at alower equipment cost than traditional device-assisted or other methods.

In a preferred embodiment, an apparatus for aiding endotrachealintubation comprises:

a funnel with a curved cannulated stem that is configured for oralinsertion into a patient's throat;

a lever arm at the tip of the stem;

an endotracheal tube; and,

wherein after the curved cannulated stem is orally inserted into thepatients throat the endotracheal tube is (a) passed through the funneland curved cannulated stem to press the lever arm into contact with thepatient's epiglottis and (b) directed by the curved cannulated stem awayfrom the esophagus and into the trachea.

In accordance with the present method and apparatus of insertingendotracheal tubes into the patient's airway, the patient is firstplaced in a prone or substantially equivalent position. The patient'smouth must be accessible to the physician or technician inserting anendotracheal tube. Once the patient is in the proper position, the mouthis opened and the patient's head tilted slightly in an attempt tostraighten the passageway from the rear of the mouth to the desiredtracheal depth.

The curved cannulated stem of the funnel may then be inserted into themouth of the patient, preferably but not necessarily with the curvatureof the cannulated stem (hook) being orthogonal to the inside of thepatient's cheek before being rotated into position. The cannulated stemmay preferably have the endotracheal tube already partially inserted, orinsertion may take place after the airway has been properly fitted.During rotation of the device into position, the hook, i.e. curvedcannulated stem, may be downstream so that the tip of the stem is towardthe patient's lungs. Ultimately, the endotracheal tube may be guidedpast the soft palate and pharynx until it rests fully inserted into thepatient's trachea.

The endotracheal tube depresses outward a perforated pad or lever arm asit is passed through tip of the cannulated stem. When so depressedoutward, the pad or lever arm holds the epiglottis in place as to reducethe likelihood of esophageal insertion. The cannulated stem may beconstructed to safely direct the tube away from the esophagus and intothe trachea at a reduced risk of damage to other part of the anatomy andrespiratory function. A ventilating means, such as an external bladderor machine lung, is attached the exposed end and funnel portion of thetube.

The manner in which the cannulated stem is inserted greatly reduces therisk of esophageal insertion of the endotracheal tube and thus the risksassociated with improper respiration. Some of the associated risksinclude brain damage, cardiac arrest, and death. Use of the cannulatedstem and method at hand likewise reduces the risk of aspiration of thestomach contents or improper lung ventilation and associated risks.Additionally, the simplicity of the apparatus typically allows forintubation in substantially less time than traditional methods.

A preferred method for endotracheal intubation comprising the steps of:

opening a patient's mouth;

inserting an cannulated stem into the patient's mouth;

-   -   manipulating the positioning of said stem as to allow for its        passage into the throat;    -   ensuring the cannulated stem is fully inserted into the        patient's throat;    -   passing an intubation tube through said cannulated stem into the        patient's trachea;    -   extending a lever arm from the tip of the cannulated stem to        hold the epiglottis out of the way of the intubation tube;    -   attaching a ventilating means to the exposed end of the        intubation tube; and    -   ventilating the patient's lungs.

The present disclosure, both as to its organization and features, may bebest understood by reference to the following description taken inconjunction with the appended drawings.

BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS

Other objectives of the disclosure will become apparent to those skilledin the art once the invention has been shown and described. The mannerin which these objectives and other desirable characteristics can beobtained is explained in the following description and attached figuresin which:

FIG. 1 is a fully rendered isometric view of a blind intubation device1000;

FIG. 2 is an isometric schematic view of the blind intubation device1000;

FIG. 3 is a cross-sectional side view of the blind intubation device1000;

FIG. 4 is front view of the blind intubation device 1000;

FIG. 5 is a normal view of the blind intubation device 1000;

FIG. 6 shows a schematic view of a lever arm 1300 (also calledperforated pad);

FIG. 7 shows a schematic view of the lever arm 1300;

FIG. 8 shows a schematic view of the lever arm 1300;

FIG. 9A an isometric schematic view of the blind intubation device 1000with the lever arm 1300 tucked into the tip 1210 of the device's 1000cannulated stem 1200;

FIG. 9B an isometric schematic view of the blind intubation device 1000with the lever arm 1300 extended out of the tip 1210 of the device's1000 cannulated stem 1200;

FIG. 10A a side view of the blind intubation device 1000 with the leverarm 1300 tucked into the tip 1210 of the device's 1000 cannulated stem1200;

FIG. 10B a side view of the blind intubation device 1000 with the leverarm 1300 extended out of the tip 1210 of the device's 1000 cannulatedstem 1200;

FIG. 11A a cross-section of the blind intubation device 1000 with thelever arm 1300 tucked into the tip 1210 of the device's 1000 cannulatedstem 1200;

FIG. 11B a cross-section of the blind intubation device 1000 with thelever arm 1300 extended out of the tip 1210 of the device's 1000cannulated stem 1200;

FIG. 12A a front view of the blind intubation device 1000 with the leverarm 1300 tucked into the tip 1210 of the device's 1000 cannulated stem1200;

FIG. 12B a front view of the blind intubation device 1000 with the leverarm 1300 extended out of the tip 1210 of the device's 1000 cannulatedstem 1200;

FIG. 13A a normal view of the blind intubation device 1000 with thelever arm 1300 tucked into the tip 1210 of the device's 1000 cannulatedstem 1200;

FIG. 13B a normal view of the blind intubation device 1000 with thelever arm 1300 extended out of the tip 1210 of the device's 1000cannulated stem 1200;

FIG. 14 is an environmental view of the blind intubation device 1000inserted into a patient's 2000 throat with the curved cannulated stem1200 orthogonal to the patient's 2000 trachea 2100;

FIG. 15 is an environmental view of the blind intubation device 1000inserted into a patient's 2000 throat with the curved cannulated stem1200 turned downstream toward the patient's 2000 trachea 2100;

FIG. 16 is an environmental view of the blind intubation device 1000inserted into a patient's 2000 throat with the curved cannulated stem1200 turned downstream toward the patient's 2000 trachea 2100 and thelever arm 1300 extended from the tip 1210 of the stem 1200 so that itholds the epiglottis 2110 away from the tip 1210 of the stem 1200;

FIG. 17 is a fully rendered isometric view of another embodiment of ablind intubation device;

FIG. 18 is an isometric schematic view of the blind intubation device;

FIG. 19 is a cross-sectional side view of the blind intubation device;

FIG. 20 is front view of the blind intubation device;

FIG. 21 is a normal view of the blind intubation device;

FIG. 22 shows a schematic view of another embodiment of a lever arm(also called perforated pad);

FIG. 23 shows a schematic view of the lever arm;

FIG. 24 shows a schematic view of the lever arm;

FIG. 25 is a side view of the blind intubation device with the lever armextended out of the tip of the device's cannulated stem;

FIG. 26 is a cross-section of the blind intubation device with the leverarm extended out of the tip of the device's cannulated stem;

FIG. 27 is a cross-sectional side view of the blind intubation device;

FIG. 28 is a normal view of the blind intubation device;

FIG. 29 is a perspective view of a tube clamp 1500;

FIG. 30 is a normal view of the blind intubation device 1000 with a tubeclamp 1500 installed on the canal 1220 and the lever arm 1300 extendedout of the tip 1210 of the device's 1000 cannulated stem 1200; and,

FIG. 31 is an environmental view of the blind intubation device 1000inserted into a patient's 2000 throat with the curved cannulated stem1200 turned downstream toward the patient's 2000 trachea 2100, the leverarm 1300 extended from the tip 1210 of the stem 1200 so that it holdsthe epiglottis 2110 away from the tip 1210 of the stem 1200, a tubeclamp 1500 installed on the canal 1220 with a tube 3000 inserted intothe canal 1220 and there held fast by the clamp 1500.

In the figures, the following reference numerals are associated with thefollowing components of the disclosure;

-   blind intubation device 1000-   funnel 1100-   cannulated stem 1200-   tip 1210-   airway or canal 1220-   lever arm or perforated pad 1300-   notch 1310-   patient 2000-   trachea 2100-   epiglottis 2110-   esophagus 2200

It is to be noted, however, that the appended figures illustrate onlytypical embodiments of this invention and are therefore not to beconsidered limiting of its scope, for the invention may admit to otherequally effective embodiments that will be appreciated by thosereasonably skilled in the relevant arts. Also, figures are notnecessarily made to scale but are representative.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

Generally disclosed are apparatuses and methods to facilitate insertionof the endotracheal tube into the patient's trachea as well as reducingthe amount of time taken for intubation (e.g., from 30 seconds to 18seconds). The disclosed apparatus and technique enables for “blind”intubation, i.e., intubation without use of a laryngoscope. Hence thedevice is referred to herein as a blind intubation device. The morespecific aspects of the invention are described with reference to thefigures.

FIG. 1 is a fully rendered isometric view of a blind intubation device1000. FIG. 2 is an isometric schematic view of the blind intubationdevice 1000. FIG. 3 is a cross-sectional side view of the blindintubation device 1000. FIG. 4 is front view of the blind intubationdevice 1000. FIG. 5 is a normal view of the blind intubation device1000. As shown in FIGS. 1 through 6 the device 1000 comprises threebasic parts:

-   1. a funnel 1100,-   2. a curved and cannulated stem 1200 with tip 1210 and airway    between the funnel 1100 and tip 1210, and-   3. a lever arm 1300 that is tucked normally tucked into the tip    1210.    Suitably, the device may be 3-D printed or molded of plastic. In a    preferred embodiment, the device is molded of plastic in two halves    and snapped together as shown in FIG. 3. The device may also be made    of metal or carved of wood.

FIG. 6 shows a schematic view of a lever arm 1300 (also calledperforated pad). FIG. 7 shows a schematic view of the lever arm 1300.FIG. 8 shows a schematic view of the lever arm 1300. As discussed ingreater detail below, the lever arm 1300 may be normally tucked into thetip of a cannulated stem and then extended out of the tip to hold back apatient's epiglottis so that a tube may be passed into the trachea ofthe patient.

FIGS. 9A, 10A, 11A, 12A, and 13A are various views of the blindintubation device 1000 with the lever arm 1300 tucked into the tip 1210of the device's 1000 cannulated stem 1200. FIGS. 9B, 10B, 11B, 12B, and13B are various views of the blind intubation device 1000 with the leverarm 1300 extended out of the tip 1210 of the device's 1000 cannulatedstem 1200. Suitably, the lever arm 1300 may be spring loaded so that itis biased to a tucked position. As discussed below, the lever arm 1300may be normally tucked into the tip 1210 of a cannulated stem 1200 andthen extended out of the tip 1210 via the force of a tube (not shown)being passed through the airway 1220 of the stem 1200. When the leverarm 1300 is extended out of the tip 1210 it suitably serves to hold backa patient's epiglottis so that a tube may be passed into the trachea ofthe patient.

FIG. 16 is an environmental view of the blind intubation device 1000inserted into a patient's 2000 throat with the curved cannulated stem1200 turned downstream toward the patient's 2000 trachea 2100 and thelever arm 1300 extended from the tip 1210 of the stem 1200 so that itholds the epiglottis 2110 away from the tip 1210 of the stem 1200.

FIGS. 14 through 16 illustrate a preferred method. In accordance withthe present method and apparatus 1000 of inserting endotracheal tubesinto the patient's 2000 airway 2100, the patient 2000 is first placed ina prone or substantially equivalent position. The patient's 2000 mouthmust be accessible to the physician or technician (not shown) insertingan endotracheal tube (not shown). Once the patient 2000 is in the properposition, the mouth is opened and the patient's 2000 head tiltedslightly in an attempt to straighten the passageway 2100 from the rearof the mouth to the desired tracheal depth.

Still referring to FIGS. 14-16, the curved cannulated stem 1200 of thefunnel may then be inserted into the mouth of the patient, preferablybut not necessarily with the curvature of the cannulated stem (hook)being orthogonal to the inside of the patient's cheek before beingrotated into position. FIG. 14 is an environmental view of the blindintubation device 1000 inserted into a patient's 2000 throat with thecurved cannulated stem 1200 orthogonal to the patient's 2000 trachea2100. The cannulated stem 1200 may have the endotracheal tube (notshown) already partially inserted, or insertion may take place after theairway 2100 has been properly fitted with the device 100 as shown inFIG. 15. FIG. 15 is an environmental view of the blind intubation device1000 inserted into a patient's 2000 throat with the curved cannulatedstem 1200 turned downstream toward the patient's 2000 trachea 2100.During rotation of the device into position (e.g., from FIGS. 14 to 15),the hook, i.e. curved cannulated stem 1200, may be downstream so thatthe tip 1210 of the stem is toward the patient's lungs. Ultimately, theendotracheal tube (not shown) may be guided past the soft palate andpharynx until it rests fully inserted into the patient's throat 2100.

Referring now to FIG. 16, the endotracheal tube (not shown) depressesoutward as it moves through the tip 1210 of the stem 1200 a perforatedpad or lever arm 1300. When so depressed outward, the pad or lever arm1300 holds the epiglottis 2110 in place as to reduce the likelihood ofesophageal insertion. The cannulated stem 1200 may be constructed with acurve to safely direct the tube away from the esophagus 2200 and intothe trachea 2100 at a reduced risk of damage to other part of theanatomy and respiratory function. A ventilating means, such as anexternal bladder or machine lung (not shown), is attached the exposedend and funnel portion 1100 of the device 1000.

The manner in which the cannulated stem 1200 is inserted greatly reducesthe risk of esophageal insertion of the endotracheal tube and thus therisks associated with improper respiration. Some of the associated risksinclude brain damage, cardiac arrest, and death. Use of the cannulatedstem and method at hand likewise reduces the risk of aspiration of thestomach or improper lung aspiration and associated risks. Additionally,the simplicity of the apparatus typically allows for intubation insubstantially less time than traditional methods.

FIG. 17 is a fully rendered isometric view of another embodiment of ablind intubation device. FIG. 17 shows a perforated pad fitted to thehooked end of the cannulated stem in the engaged position and funnelwith wings fitted to the opposite end of the stem. FIG. 18 is anisometric schematic view of the blind intubation device. FIG. 18 showsthe perforated pad in the disengaged position. FIG. 19 is across-sectional side view of the blind intubation device. FIG. 19 showsthat the stem tucks away the perforated pad. FIG. 19 also shows theperforated pad in the disengaged position as well as the general contourand dimensions of the cavities within the airway associated with aparticular embodiment. FIG. 20 is front view of the blind intubationdevice. FIG. 20 shows the perforated pad in the disengaged position andthe funnel's dimensions and respective positions in this embodiment.FIG. 21 is a normal view of the blind intubation device. FIG. 21 is aschematic normal to the plane on which the funnel of this particularembodiment of cannulated stem lie. This view of FIG. 21 shows anembodiment in which the fitting means employed to fix the perforatedflap is a traditional hinge utilizing a spring as an engagement means.

FIG. 22 shows a schematic view of another embodiment of a lever arm(also called perforated pad). FIG. 23 shows a schematic view of thelever arm. FIG. 24 shows a schematic view of the lever arm. Thisparticular embodiment uses a pad with two large holes. Other embodimentsmay employ a different number or different shapes of holes. FIG. 25 is aside view of the blind intubation device with the lever arm extended outof the tip of the device's cannulated stem. FIG. 26 is a cross-sectionof the blind intubation device with the lever arm extended out of thetip of the device's cannulated stem.

FIG. 27 is a cross-sectional side view of another alternate embodimentof a blind intubation device. FIG. 28 is a normal view of the blindintubation device.

FIG. 29 is a perspective view of a tube clamp 1500. Suitably, the clamp1500 may be installed over the canal 1220 of a blind intubation device1000 to ensure a tube 3000 (FIG. 31) is not accidentally provided toodeep into a trachea 2100 during installation or afterward. FIG. 30 is anormal view of the blind intubation device 1000 with a tube clamp 1500installed on the canal 1220 and the lever arm 1300 extended out of thetip 1210 of the device's 1000 cannulated stem 1200. FIG. 31 is anenvironmental view of the blind intubation device 1000 inserted into apatient's 2000 throat with the curved cannulated stem 1200 turneddownstream toward the patient's 2000 trachea 2100, the lever arm 1300extended from the tip 1210 of the stem 1200 so that it holds theepiglottis 2110 away from the tip 1210 of the stem 1200, a tube clamp1500 installed on the canal 1220 with a tube 3000 inserted into thecanal 1220 and there held fast by the clamp 1500.

Other assembly methods may be practiced depending on the use ofalternative embodiments described herein, and will be readily apparentto those skilled in the art.

In one preferred embodiment, the engagement means comprises a spring orspring-like feature which pushes on the perforated pad, causing said padto swivel and make contact with the epiglottis.

In some preferred embodiments, the eccentricity of the airway'scurvature will vary as to allow for use on patients with varying throatdimensions.

Although the method and apparatus is described above in terms of variousexemplary embodiments and implementations, it should be understood thatthe various features, aspects and functionality described in one or moreof the individual embodiments are not limited in their applicability tothe particular embodiment with which they are described, but insteadmight be applied, alone or in various combinations, to one or more ofthe other embodiments of the disclosed method and apparatus, whether ornot such embodiments are described and whether or not such features arepresented as being a part of a described embodiment. Thus the breadthand scope of the claimed invention should not be limited by any of theabove-described embodiments.

Terms and phrases used in this document, and variations thereof, unlessotherwise expressly stated, should be construed as open-ended as opposedto limiting. As examples of the foregoing: the term “including” shouldbe read as meaning “including, without limitation” or the like, the term“example” is used to provide exemplary instances of the item indiscussion, not an exhaustive or limiting list thereof, the terms “a” or“an” should be read as meaning “at least one,” “one or more,” or thelike, and adjectives such as “conventional,” “traditional,” “normal,”“standard,” “known” and terms of similar meaning should not be construedas limiting the item described to a given time period or to an itemavailable as of a given time, but instead should be read to encompassconventional, traditional, normal, or standard technologies that mightbe available or known now or at any time in the future. Likewise, wherethis document refers to technologies that would be apparent or known toone of ordinary skill in the art, such technologies encompass thoseapparent or known to the skilled artisan now or at any time in thefuture.

The presence of broadening words and phrases such as “one or more,” “atleast,” “but not limited to” or other like phrases in some instancesshall not be read to mean that the narrower case is intended or requiredin instances where such broadening phrases might be absent. The use ofthe term “assembly” does not imply that the components or functionalitydescribed or claimed as part of the module are all configured in acommon package. Indeed, any or all of the various components of amodule, whether control logic or other components, might be combined ina single package or separately maintained and might further bedistributed across multiple locations.

Additionally, the various embodiments set forth herein are described interms of exemplary block diagrams, flow charts and other illustrations.As will become apparent to one of ordinary skill in the art afterreading this document, the illustrated embodiments and their variousalternatives might be implemented without confinement to the illustratedexamples. For example, block diagrams and their accompanying descriptionshould not be construed as mandating a particular architecture orconfiguration.

All original claims submitted with this specification are incorporatedby reference in their entirety as if fully set forth herein.

I claim:
 1. An apparatus for aiding endotracheal intubation comprises: afunnel with a curved cannulated stem that is configured for oralinsertion into a patients throat; a lever arm tucked into a tip of thestem so that a nub of the lever arm is disposed within the curvedcannulated stem; an endotracheal tube; and, wherein after the curvedcannulated stem is orally inserted into the patients throat theendotracheal tube is (a) passed through the funnel and curved cannulatedstem to press the nub and extend the lever arm from the tip into contactwith the patient's epiglottis and (b) directed by the curved cannulatedstem away from the esophagus and into the trachea.
 2. The apparatus ofclaim 1, wherein the cannulated stem additionally comprises at least twowings fixed to the straight end of the airway, the wings configured toprevent the airway from slipping further than desired into the patient'smouth.
 3. The apparatus of claim 1, wherein the cannulated stemadditionally comprises a ring fixed to the straight end of the airway,the ring configured to prevent the airway from slipping further thandesired into the patient's mouth.
 4. The apparatus of claim 1, whereinthe lever arm includes a perforated pad disposed over the end of thecannulated stem to be inserted first into the patient's mouth.
 5. Theapparatus of claim 4, wherein the perforated pad has substantially thesame diameter as the tip of the cannulated stem to which it is attached.6. The pad of claim 4, wherein said pad is engaged via an engagementmeans.
 7. The pad of claim 4, wherein said pad has at least oneperforation sufficiently large as to allow for adequate air passageshould the engagement means fail to engage and the airway remainsclosed.
 8. A blind endotracheal intubation apparatus comprising: afunnel and; a endotracheal tube and; a cannulated stem and; a lever. 9.The apparatus of claim 8 wherein the cannulated stem comprises wingsconfigured to prevent the over insertion of said cannulated to stem. 10.The apparatus of claim 8 wherein the lever is connected by a hinge to aproximal end of the cannulated stem, the lever configured to prevent theepiglottis from occluding said cannulated stem.
 11. The apparatus ofclaim 10 wherein the lever opens from said cannulated stem to make a130-135 degree angle relative to a plane parallel to the proximal end ofsaid cannulated stem.
 12. The apparatus of claim 8 wherein thecannulated stem has a hole 14 mm in diameter that travels unimpeded fromsaid proximal end to a distal end.
 13. An endotracheal intubationapparatus comprising: a funnel; a curved cannulated stem configured tohave a circular shape; a endotracheal tube configured to be guidedthrough said cannulated stem and, a lever stored in said cannulated stemconnected by a hinge to deploy said lever
 14. The apparatus of claim 13,wherein said funnel when deployed will deposit said lever to contact anepiglottis.
 15. The apparatus of claim 13 wherein said cannulated stemis configured to form a curved shape.
 16. The apparatus of claim 13wherein the cannulated stem is configured to allow said endotrachealtube to pass though said cannulated stem.
 17. The apparatus of claim 13wherein the apparatus is made from metal or plastic.
 18. The apparatusof claim 13 wherein the planes parallel to both the proximal and thedistal ends will have normal vectors that are not parallel.
 19. Theapparatus of claim 13 wherein a tube clamp is attached by sharingcongruent geometries to said endotracheal tube.
 20. The apparatus ofclaim 13 wherein the cannulated stem is configured to not enter anesophagus.